INTESTINAL-OBSTRUCTION AND PERITONITIS RESULTING FROM GASTROINTESTINAL HISTOPLASMOSIS IN AN AIDS PATIENT

Gastrointestinal histoplasmosis complicated by intestinal obstruction and peritonitis has not been reported. We report a case of gastrointes tinal histoplasmosis in a 27-year-old patient with acquired immunodefi ciency syndrome (AIDS). The patient was a Chinese man from Thailand wi th a history of intravenous drug use and unprotected sex with female p rostitutes. He was admitted fbr prolonged fel er, abdominal pain, and diarrhea. Colonoscopy revealed volcano-like ulcers and tumors, while c omputed tomography of the abdomen showed a colon tumor and hypoattenua ted lymphadenopathy of the retroperitoneum. Histopathologic examinatio n as well as cultures of colon biopsy specimens and an aspirate from t he retroperitoneal lymphadenopathy revealed Histoplasma capsulatum. In testinal obstruction and peritonitis requiring surgical intervention d eveloped, despite amphotericin B therapy. Histoplasmosis should be inc luded in the differential diagnosis in AIDS patients who present with colon tumors, retroperitoneal lymphadenopathy, and peritonitis.